Surgeon fired for injecting patient in wrong hip and trying to hide it
A surgeon who mistakenly injected a patient with local anaesthetic and steroids in the wrong hip and then tried to cover it up has been struck off.
Dr Narayanasamy Raghuraman was working at the Spire Hull and East Riding Hospital in Anlaby when he injected the woman's right hip with local anaesthetic and steroid injections instead of the left hip.
It remains unclear whether the patient suffered long-term damage as a result of the error.
A tribunal found the doctor's actions showed a 'serious departure from good medical practice and throughout his evidence giving he continued to show elements of dishonesty.
Further allegations of incompetence, errors and not fully obtaining consent before operations relating to three other patients were also made against him but were not fully proven. He was found to have made a mistake while treating Patient PM at the hospital between 2012 and 2018.
The hospital carried out an investigation after which the General Medical Council (GMC) was alerted.
After the procedure, he took various steps to justify his actions and try to cover up his mistake.
Dr Raghuraman dishonestly amended the consent form and also changed the markings on the site of injection.
At the Medical Practitioners Tribunal several other allegations about Dr Raghuraman's actions were made but not proven, such as inappropriately advising a patient dubbed 'RE' to proceed with a hip replacement and then performing it when it was not clinically necessary.
He was also accused of advising another - Patient GS - to undergo a hip arthroscopy (an invasive procedure to diagnose any problems) that was potentially clinically harmful and failing to obtain fully informed consent.
It was also reported he inappropriately advised Patient KF to undergo a knee arthroscopy that was not clinically indicated and performed it without obtaining consent.
Concerns were initially raised with the General Medical Council (GMC) on May 25, 2018 following a local investigation by the Spire Hull and East Riding Hospital.
Mark Monaghan, on behalf of the GMC, told the hearing issues relating to Patient PM involved several distinct aspects of dishonest behaviour clearly amounting to misconduct.
He said: 'This is not only misconduct in itself but also goes to the issues of the doctor's integrity and the public's trust in the profession.'
He also pointed out Dr Raghuraman was suspended from practice for four months in 2010 for misleading his supervisor over the submission of two research papers to journals, and then giving a dishonest account when his behaviour was being investigated.
Mr Monaghan submitted that Dr Raghuraman's fitness to practise is currently impaired.
Dr Raghuraman told the tribunal his clinical capabilities have never been below standards.
He submitted that while he was a very busy surgeon, his clinical outcomes have been 'nothing short of excellent'.
However, he said: 'I deeply regret my actions towards Patient PM.'
Dr Raghuraman admitted that when the mistake occurred, he lost focus and forgot how to handle the situation. He felt 'snowballed into a lot of things' which led him to behave in a manner that he is ashamed of.
He said: 'I regret that I failed to set things right when given the opportunity immediately after the incident.
'I meant no harm to the patient, and I will live with the guilt of my errors forever.
He admitted it was a human error which could have been avoided and his biggest mistake was subsequently trying to cover this up.
Dr Raghuraman submitted that he has gained tremendous insight about mistakes and how they must be remedied.
He said he offered a heartfelt apology to Patient PM which he believes to be the most important thing and he 'hopes and prays' Patient PM has forgiven him.
He told the tribunal he has undergone intense training courses and has even become a qualified yoga instructor and practises meditation to help deal with stress and pressure.
In the findings, the tribunal noted that Dr Raghuraman's dishonesty had been prolonged, not only to the patient but to his colleagues.
He even continued to insist the MRI scan he ordered was necessary during the hearing when it was clearly not.
The tribunal said: 'We are concerned that Dr Raghuraman had continued with his dishonesty even during his current fitness to practise hearing as he had maintained his view that the MRI scan which he ordered was clinically needed despite the evidence to the contrary.
'Viewing this alongside the other measures taken by Dr Raghuraman to cover up his initial wrongdoing, we determined that the series of dishonest acts amounts to serious misconduct.'
The tribunal also questioned the veracity of Dr Raghuraman's remorsefulness.
It said: 'While Dr Raghuraman in his submissions had expressed that he felt deep shame and contrition, his reflections appeared mainly to centre around the impact of his dishonesty on him and his family.
'Although he regretted the impact on the patient, he did not mention the impact on colleagues, the profession and on the wider public.'
'The fact we consider Dr Raghuraman had continued to either minimise or deny certain elements of dishonesty during his evidence, and the history of previous dishonesty, we are satisfied that there is a high risk of repetition of his dishonest behaviour.
'We consider that public confidence in the profession would be undermined if a finding of impairment were not made in this case.
'We have therefore determined that Dr Raghuraman's fitness to practise is impaired by reason of misconduct.'
Having concluded that his fitness to practise has been impaired the tribunal decided Dr Raghuraman should be struck off.
It said: 'We note that Dr Raghuraman's conduct represented a serious departure from good medical practice and he had also shown a deliberate disregard for the principles therein.
'We conclude that erasure is the only appropriate sanction to protect patients, promote and maintain public confidence in the medical profession, and to uphold proper professional standards and conduct for members of the profession.'
Dr Raghuraman has 28 days to appeal the decision.